Abstract

Background: Intra-abdominal vascular injury (IAVI) is uncommon but continues to be associated with high mortality rates despite technological advances in the past decades. In light of these ongoing developments, we reviewed our contemporary experience with IAVI in an attempt to clarify and refine our management strategies and the outcome of these patients.

Methods: We retrospectively reviewed the charts of all patients admitted between January 2011 and December 2014 at a major trauma centre in South Africa who were found to have an IAVI during laparotomy for trauma. We collected demographic and clinical data including mechanism of injury, location and severity of the injury, concurrent injuries, physiologic parameters and clinical outcome.

Conclusion: The mortality rate for IAVI remains high despite decades of operative experience in high-volume centres. Open operative techniques alone are unlikely to achieve further reduction in mortality rates. Integration of endovascular techniques may provide an alternative strategy to improve outcomes.

Affiliations: From the Department of General Surgery, Wessex Deanery, Wessex, United Kingdom (Weale); Pietermaritzburg Metropolitan Trauma Service, Department of Surgery, University of KwaZulu-Natal, Durban, South Africa (Kong, Manchev, Bekker, Oosthuizen, Laing, Bruce, Clarke); the School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa (Brysiewicz); and the Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa (Clarke).